Building a Rational Clinical Information System for Older Adults in Acute Care: The Role of the interRAI Acute Care...

Prior research has identified gaps in the ability of hospital systems to efficiently and meaningfully characterize older adults with complex health needs. We recruited community-dwelling older adults presenting to 10 Emergency Departments (EDs) across Ontario, Quebec, and Newfoundland, Canada, from April 2017 to July 2018. We deployed a staged assessment strategy based on the interRAI Acute Care Suite to identify and characterize older adults at high risk of Alternate Level of Care designation. More than 5,700 patients underwent the ED-Screener, 53.3% of whom were not self-reliant. Subsequent focused screening and assessment identified 457 patients, 93.3% of whom were not self-reliant, and who had significant impairments in function, mobility, and cognition, as well as social vulnerability. A staged assessment approach based upon the interRAI Acute Care Suite can efficiently identify older adults with risk factors for Alternative Level of Care designation.